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ICD-10 Guide
ICD-10 CodesE11.51

E11.51

Billable

Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 E11.51 is a billable code used to indicate a diagnosis of type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene.

Key Diagnostic Point:

E11.51 refers to a specific complication of Type 2 diabetes mellitus characterized by diabetic peripheral angiopathy, which involves damage to the blood vessels in the extremities due to prolonged high blood sugar levels. This condition can lead to reduced blood flow, resulting in symptoms such as pain, numbness, and increased risk of infections. Unlike diabetic peripheral angiopathy with gangrene, this code indicates that there is no tissue death present. Management of this condition often includes strict glycemic control, typically monitored through HbA1c levels, which should ideally be maintained below 7% to prevent further vascular complications. Insulin therapy may be required for some patients, especially those who cannot achieve adequate control with oral hypoglycemic agents. Regular foot examinations and lifestyle modifications are crucial in managing this condition to prevent progression to more severe complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between types of diabetic complications
  • Understanding the nuances of peripheral angiopathy versus other forms of vascular complications
  • Monitoring and documenting HbA1c levels accurately
  • Insulin management complexities in patients with multiple comorbidities

Audit Risk Factors

  • Inadequate documentation of peripheral angiopathy
  • Failure to document HbA1c levels and treatment plans
  • Misclassification of diabetic complications
  • Lack of follow-up notes on patient management

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed records of blood glucose levels, HbA1c results, and treatment plans including insulin management.

Common Clinical Scenarios

Patients presenting with poorly controlled diabetes and symptoms of peripheral vascular disease.

Billing Considerations

Endocrinologists must ensure comprehensive documentation of all diabetes-related complications to support coding.

Podiatry

Documentation Requirements

Foot examination findings, treatment of foot ulcers, and vascular assessments.

Common Clinical Scenarios

Patients with diabetic foot problems or peripheral neuropathy requiring intervention.

Billing Considerations

Podiatrists should document the absence of gangrene clearly to avoid misclassification.

Coding Guidelines

Inclusion Criteria

Use E11.51 When
  • According to ICD
  • 10 guidelines, E11
  • 51 should be used when a patient has Type 2 diabetes with documented diabetic peripheral angiopathy but without gangrene
  • Coders must ensure that the documentation supports the diagnosis and that there is no indication of gangrene

Exclusion Criteria

Do NOT use E11.51 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits for diabetes management.

Documentation Requirements

Document patient's diabetes management plan, including HbA1c levels and any complications.

Specialty Considerations

Endocrinologists should ensure comprehensive documentation of diabetes-related complications.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of diabetes-related complications, improving the accuracy of patient records and facilitating better management of diabetes care.

Resources

Clinical References

  • •
    American Diabetes Association

Coding & Billing References

  • •
    American Diabetes Association

Frequently Asked Questions

What is the significance of HbA1c levels in managing E11.51?

HbA1c levels are crucial in managing E11.51 as they reflect the patient's average blood glucose levels over the past 2-3 months. Maintaining HbA1c below 7% is essential to prevent further complications associated with diabetes, including peripheral angiopathy.